Comparison between laparoscopic ovulation induction and gonadotropin ovulation induction

Laparoscopic ovarian drilling

Gonadotropin ovulation induction

Advantages

One-time, minimally invasive procedure

Normalizes endocrinologic and ultrasonographic abnormalities

Restores ovulatory cycles for many years

Pregnancy and live birth rates are comparable to gonadotropin ovulation induction with no increase in multiple pregnancy or OHSS

Improves response to gonadotropin superovulation for IVF

May improve acne and hirsutism

Comparable pregnancy and live birth rates to ovarian drilling without surgery

Widespread availability

Disadvantages

Surgical risks inherent with laparoscopy

Postoperative adhesions

Diminished ovarian reserve versus normalization of elevated AMH and antral follicle counts

Few clinicians in the United States offer it

Significantly higher risk for multiple pregnancy

Higher risk of OHSS

Greater cost compared with ovarian drilling

High patient inconvenience due to daily injections and frequent visits for monitoring

No benefit beyond the treatment cycle

OHSS: ovarian hyperstimulation syndrome; IVF: in vitro fertilization; AMH: anti-Müllerian hormone.

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